Major abdominal surgery for a number of diseases involving different parts of the gastro-intestinal and urinary tract can result in a patient being left with an abdominal stoma. The three most common types of abdominal stoma are the colostomy, the ileostomy, and the ileal conduit. In the case of an ileostomy, ileal conduit, and many colostomy operations, the patient is unable to control the passage of bodily waste material and must rely upon an appliance attached to their body to collect this material.
Numerous appliances have been proposed for this purpose. Most can be characterized as either a one-piece or a two-piece system. The one-piece appliance conventionally consists of a pouch having an opening in one sidewall for the stoma around which a plastic faceplate is permanently bonded. The faceplate includes an outer layer of adhesive material which is designed to affix the appliance directly to the body or to an intermediate skin barrier or sealing washer. The two-piece appliance conventionally consists of a mounting ring that is supported on the body by means of an elastic belt.
Recently, the two-piece appliance disclosed by Steer et al. in British Patent Nos. 1,571,657, 1,586,823 and 1,586,824 has achieved considerable commercial success. The Steer et al. appliance consists of a skin barrier having a projecting rib type coupling member affixed to its outer surface and a pouch with a channel shaped coupling member encircling the stoma opening in the pouch sidewall. The pouch can be securely attached to the skin barrier by snapping onto the rib. The skin barrier employed by Steer et al. consists of a layer of pressure sensitive adhesive having an outer water insoluble polyethylene film to which the rib coupling member is affixed.
The act of assembling the two piece system of Steer et al. results in pressure being exerted against the body. This may be undesirable, particularly for the period of time immediately following surgery. Proposals for overcoming this difficulty have involved displacement of the rib coupling member from the surface of the skin barrier. This permits the fingers to be inserted beneath the rib so as to cushion the force exerted when the pouch is snapped onto the rib. Jensen in U.S. application Ser. No. 503,754 filed June 13, 1983 discloses such a system where the intermediate member includes a series of accordion-like folds.